Organization Name: | BLUEGRASS MIDDLE SCHOOL SATELLITE CLINIC |
NPI Number: | 1891079554 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA M SIMS (DIRECTOR) |
Mailing Address: | 170 W A Jenkins Rd Elizabethtown |
State: | KY US |
Postal Code: | 427018451 |
Phone Number: | 2707691601 |
Fax Number: | 2707657274 |
NPI Enumeration Date: | 09/29/2011 |
NPI Last Update Date: | 09/29/2011 |
Replacement NPI: | 0 |
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NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
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